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A distinct variant of mixed dysarthria reflects parkinsonism and dystonia due to ephedrone abuse

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

A distinctive alteration of speech has been reported in patients suffering from ephedrone-induced parkinsonism. However, an objective assessment of dysarthria has not been performed in ephedrone users. We studied 28 young Caucasian men from Georgia with a previous history of ephedrone abuse and compared them to 25 age-matched healthy controls. Speech examination, brain MRI, and NNIPPS-Parkinson plus scale were performed in all patients. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analyses of 15 speech dimensions. We revealed a distinct variant of mixed dysarthria with a combination of hyperkinetic and hypokinetic components representing the altered motor programming of dystonia and bradykinesia in ephedrone-induced parkinsonism. According to acoustic analyses, all patients presented at least one affected speech dimension, whereas dysarthria was moderate in 43 % and severe in 36 % of patients. Further findings indicated relationships between motor subscores of dystonia and bradykinesia and speech components of loudness (r = −0.54, p < 0.01), articulation (r = 0.40, p < 0.05), and timing (r = −0.53, p < 0.01). In ephedrone-induced parkinsonism a prominent mixed hyperkinetic–hypokinetic dysarthria occurs that appears related to marked dystonia and bradykinesia and probably reflects manganese induced toxic and neurodegenerative damage to the globus pallidus internus and substantia nigra.

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Acknowledgments

We are grateful to H. E. Ivan Jestrab, the Czech Ambassador in Georgia for his personal support, to Nina Mikeladze for neuropsychological testing of patients, to Prof. Jonas Bergquist for testing the manganese content of patient hair, to Prof. Giorgi Menabde for his support, and to Aaron Rulseh, MD for his thoughtful English corrections. This study was supported by the Czech Science Foundation (GACR 102/12/2230), Czech Ministry of Health (NT/12288-5 and NT/14181-3), and Charles University in Prague (PRVOUK-P26/LF1/4 and GA UK 441611). MRI examination in the Research Institute of Clinical Medicine in Tbilisi was enabled by the grant from the Czech Development Agency. JSC Bank Republic Tbilisi supported customs expenses.

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The authors declare that they have no conflict of interest

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Authors and Affiliations

  1. Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic

    Jan Rusz

  2. Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

    Jan Rusz, Cecilia Bonnet, Hana Brožová & Evžen Růžička

  3. Institute of Medical Research, Ilia State University, Tbilisi, Georgia

    Marika Megrelishvili, Michael Okujava & Irine Khatiashvili

  4. Department of Neurology, S. Khechinashvili University Hospital, Tbilisi, Georgia

    Marika Megrelishvili, Irine Khatiashvili, Madona Sekhniashvili & Marina Janelidze

  5. Research Institute of Clinical Medicine, Tbilisi, Georgia

    Michael Okujava

  6. Neurology Service, Hospital Clínic de Barcelona. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Universitat de Barcelona, Barcelona, Spain

    Eduardo Tolosa

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  1. Jan Rusz
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  2. Marika Megrelishvili
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  3. Cecilia Bonnet
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  10. Evžen Růžička
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Correspondence to Evžen Růžička.

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Rusz, J., Megrelishvili, M., Bonnet, C. et al. A distinct variant of mixed dysarthria reflects parkinsonism and dystonia due to ephedrone abuse. J Neural Transm 121, 655–664 (2014). https://doi.org/10.1007/s00702-014-1158-6

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  • DOI: https://doi.org/10.1007/s00702-014-1158-6

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